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Evaluation of the prevalence of hearing and balance symptoms in patients with autoimmune rheumatic diseases presenting to the Rheumatology Department using the Dizziness Handicap Inventory (DHI) and Hearing Handicap Inventory Adults/Elderly (HHIA/E) – a pilot study

Author

Ng, Bryan Choon Yang

Date of Issue

2017

School

Lee Kong Chian School of Medicine (LKCMedicine)

Abstract

Introduction Autoimmune Inner Ear Disease (AIED) is a diagnosis which suggests autoimmune mediation of inner ear pathology, but is as yet not a widely recognized clinical entity. This study aims to determine the prevalence of hearing and balance symptoms in a cohort of patients with autoimmune disease. Methods This is a prospective cross sectional study of 183 patients with a primary autoimmune condition attending specialist appointment at a rheumatology clinic. They are screened, consented, and interviewed using a Data Collection Form, Dizziness Handicap Inventory, and Hearing Handicap Inventory Adults/Elderly, to assess their experience of hearing and balance symptoms and functional impairment. Results Amongst study participants, 15.8% experienced hearing loss, 24.0% experienced non-vertiginous dizziness, 2.2% experienced tinnitus, and none experienced vertigo at the time of interview. 26.8% of study participants experienced at least one hearing or balance symptom at the time of interview. 20.2% experienced hearing loss, 27.9% experienced non-vertiginous dizziness, 32.8% experienced tinnitus, and 18.6% experienced vertigo at some point in their life. At 56.3%, a majority of study participants experienced at least one hearing or balance symptom at some point in their life. With regards to functional impairment, 91.2% of study participants had no balance impairment, 5.5% had mild balance impairment, 2.7% had moderate balance impairment and 0.5% had severe balance impairment. 97.3% of study participants had no hearing impairment, 2.7% had mild or moderate hearing impairment and none had severe hearing impairment. Conclusion Prevalence of hearing and balance symptoms in this cohort indicate that it may be feasible to screen for and follow up such symptoms in rheumatology or immunology clinics, and conduct further research in this area.